Municipality of Anchorage v. Carter

COMPTON, Justice,

dissenting in part.

AS 23.30.095(a) provides in part:

It shall be additionally provided that, if continued treatment or care or both beyond the two-year period is indicated, the injured employee has the right of review by the board. The board may authorize continued treatment or care or both as the process of recovery may require.

The court holds: 1) the presumption of compensability provided by AS 20.30.120(a) will satisfy the employee’s burden of proof as to whether continued treatment or care is indicated, absent substantial evidence to the contrary; 2) if the presumption is unre-butted or the employee proves following rebuttal of the presumption that treatment or care is indicated, the board retains discretion not to award treatment or care, or to award treatment or care different from that requested; and 3) the phrase “process of recovery” includes palliative care.

The superior court noted that the “real issue is whether [Carter] is entitled to further chiropractic treatment even if it does not cure him or assist in his return to work." Although irrelevant to this issue, the superior court went on to remark that the board had not applied the statutory presumption contained in AS 23.30.120(a) to Carter’s claim for continued treatment or care. The court remanded the case with directions that the board apply the presumption to Carter’s claim.

The superior court’s statement of the issue is correct, and indeed this court eventually addresses that issue. In the process it decides two issues that are not raised by Petitioners and that are irrelevant to the issue noted by the superior court.

Petitioners never argue that continued treatment or care was not indicated.1 Clearly it was, as one can say with almost certainty that it always will be. The statutory threshold amounts to no more than a “bring in a letter from your doctor” requirement.

As I understand the court’s decision, if a claimant who has already been receiving treatment or care for two years brings in a letter from his or her health care provider stating that continued treatment or care is indicated, that will constitute sufficient evidence to establish the preliminary link necessary to raise a presumption that continued treatment or care is indicated. The claimant then is entitled to board review, presumably to prove that continued treatment or care is needed and just what form *667it should take, and convince the board that it ought to grant the request. The board then exercises the discretion this court confirms is within the board’s power to exercise, and either grants or denies the claimant’s request. I cannot imagine what evidence from a claimant’s health care provider would be rejected as not indicating continued treatment or care unless it says so expressly, in which case there is no issue.

I do not disagree that the board retains discretion to continue treatment or care, or to require that it be provided in a manner other than the claimant requests, or to deny it altogether. Also, to the extent that the board believed it was foreclosed from awarding palliative treatment or care, I agree that a remand is necessary. However, no issue was raised regarding Carter’s indication of continued treatment or care; thus there is no need to address it. Furthermore, to apply a presumption to whether continued treatment or care is indicated is of no practical significance. The court does not suggest what is to be gained by holding that evidence that continued treatment or care is indicated raises a presumption that continued treatment or care is indicated. Since the reasons for establishing presumptions in workers’ compensation law do not exist when all that must be established is that continued treatment or care is indicated, there is no basis for holding that the statutory presumption applies. The presumption is as illusory as it is nonsensical.

. Petitioners assert that the presumption of compensability does not apply to any medical claim, and that the presumption is not intended "to assist Mr. Carter in establishing his continued need for chiropractic care." (Emphasis added). They assert that Mr. Carter has the burden of establishing his need for continued treatment by a preponderance of the evidence, an assertion which I believe to be correct and which reflects the position taken by the board.